The Revenue Integrity Specialist optimizes the payment cycle for retail and specialty pharmacy claims, ensuring accurate workflow and payment verification
Job Summary
The Revenue Integrity Specialist optimizes the payment cycle for retail and specialty pharmacy claims, ensuring accurate workflow and payment verification.
This role involves reconciling payer remittances, understanding claim exceptions and partial payments, and proactively communicating to resolve discrepancies.
The position requires advanced knowledge of pharmacy benefit and medical benefit claims billing regulations and strong computer skills, including Microsoft Excel and Teams.
Matching Summary
The Revenue Integrity Specialist optimizes the payment cycle for retail and specialty pharmacy claims, ensuring accurate workflow and payment verification.
Skills & Requirements
Must-have
pharmacy audit and reconciliation
payer remittances
claim exceptions
secondary billing processes
Microsoft Excel
Microsoft Teams
Nice-to-have
proactive follow-up
scalable process improvements
advocate for efficient claim resolution
team collaboration
Key Requirements
Bachelor's degree or equivalent experience
2 years relevant experience
Registered technician with State of Ohio Board of Pharmacy